Suture needle holding surgical instrument

ABSTRACT

A surgical instrument for holding a suture needle is disclosed. The instrument is of scissors configuration with elongated arms having finger loops at one end and jaws at the other end to grasp a suture needle. This improved instrument has specialized jaws containing a transverse channel that securely holds a suture needle at a right angle to the axis of the needle holder. The width of the transverse channel automatically adjusts to the size of the suture needle as it is being placed in the needle holder. This improved configuration significantly reduces the long standing problem of suture needle twisting or rotation in the needle holder jaws as the surgeon passes the needle through tissue.

FIELD OF THE INVENTION

The subject invention relates generally to surgical instruments, andmore particularly to a holding instrument, for a suture needle.

BACKGROUND OF THE INVENTION

It is common surgical practice for a physician to join various tissuesby passing a needle with attached suture through the tissue. The sutureis then tied to approximate the tissues. There are several prior artplier-like instruments available for gripping and holding sutureneedles. A conventional instrument for passing the needle through thetissues is a needle holder which usually has a pair of movable, opposedjaws connected to a pair of handles. The handles in turn have a scissorconfiguration with a locking ratchet mechanism to maintain grippingpressure on the needle held in the jaws of the needle holder.

Needle holder jaws commonly have a tungsten carbide, serrated surface ina diamond or cross-hatched pattern to enhance the firmness with whichthe needle is grasped. The ratchet mechanism between the scissor handlesis locked as the handles close thereby maintaining firm grippingpressure on the suture needle. Despite this construction, needles arefrequently subject to twisting or slipping in the jaws of needle holdersas they pass through tissue. Normally the surgeon releases the ratchetmechanism only after the needle has safely passed through the tissue. Ifduring passage of the suture needle, the needle twists or moves off thedesired axis of travel, tissue may be torn, needles may be lost, and theoperation time prolonged. Twisting movement of a suture needle in theneedle holder jaw is a frustrating and dangerous problem which has notbeen solved by prior art.

SUMMARY OF THE INVENTION

It is an object of the present invention to provide a surgical needleholder that securely holds a suture needle as it passes through tissue.It is an object to minimize slipping or twisting of the suture needle inthe jaws of the needle holder as the needle passes through tissue. Priorart has not solved the long standing problem of unwanted motion of thesuture needle while still in the grasp of the needle holder.

The present invention consists of a surgical needle holder withfinger-loop handles which have a ratchet locking mechanism connected totwo elongated scissoring members that in turn define specializedopposing jaws that hold the suture needle. In this improved inventionthe jaws of the needle holder have a distal transverse channel thatsecurely hold the suture needle at a right angle as it passes throughtissue. The transverse channel in the needle holder jaw is of adjustablewidth to accomodate suture needles of different size. The width iseasily adjusted during a surgical procedure, so that needles of variouswidth can be accommodated without changing needle holders. In addition,the floor of the transverse channel is of ribbed design to mate with thesurface of the suture needle.

Both jaws of the needle holder have a mirror-imaged adjustabletransverse channel design, so there is no top or bottom orientationrequired for the needle holder. The needle holding transverse channeladjusts to the diameter of the needle by a biasing sliding member of theneedle holder jaw. This design allows quick placement of the needle inthe holder and maintains proper, secure alignment of the needle at rightangles to the jaws of the needle holder.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a side view of the subject needle holder showing a sutureneedle positioned in the specialized transverse channels 28, 30.

FIG. 2 is a cross section of the needle holder jaw showing thelongitudinal grooves in which the top sliding member 38 moves.

FIG. 3 is a top view of the needle holder jaw showing the sliding member38, distal transverse channel 28 and proximal spring compartment 44.

FIG. 4a is an oblique view of the needle holder jaw showing thetransverse channel 28 with varying width maintained by sliding member38.

FIG. 4b is a cross section of the preferred suture needle.

FIG. 5 is a side view of the transverse channel with a small sutureneedle.

FIG. 6 is a side view of the transverse channel with a large sutureneedle.

FIG. 7 is a side view of the needle holder jaw showing theremovable/disposable feature for the entire jaw mechanism.

DETAILED DESCRIPTION OF THE INVENTION

FIG. 1 shows the needle holding instrument of the present invention withthe embodiment of a specialized distal transverse channel in the jaws ofthe needle holder to securely grasp a suture needle. The needle holder14 is preferably constructed of surgical stainless steel.

At the proximal end finger loops 16 and 18 are of a size to accept thumbor finger within the loop. The finger loops are in turn connected toelongated arms 6 and 8.

Protruding at or near the junction of the finger loops 16, 18 and theelongated arms 6, 8 is a conventional locking ratchet mechanism 22. Theratchet lock 22 consists of two short members, at the junction of thefinger loops with the elongated arms, and perpendicular to the arms ofthe needle holder. These members have matching notches on their opposingsurfaces which engage one another, locking, as the finger loops arebrought together. Such locking ratchet mechanism is well known to theart.

The elongated arms are of equal length and terminate at a pivot joint20. Conventionally the pivot joint 20 is constructed such that theelongated arms of the needle holder terminate in a short, flat, widendedarea. Any pivot method can be used, traditionally, the flat area of onearm passes thru a matched opening in the other arm with both beingunited to one another by a pin passing through the center of the flatzone. Both arms pivot about this pin establishing the scissors action ofthe needle holder. This configuration allows the distal jaws to becentered on one another rather than offset as is the case with the usualcutting scissors. The elongated arms for open surface surgery areshorter than those in the case of laparoscopic surgery.

The finger loops and elongated arms allow the surgeon to grasp theinstrument and apply pressure to close it. Once closed, the ratchetmechanism locks to maintain the closed position. The ratchet mechanismis opened by the surgeon applying opposing pressure to the finger loops.The pivot joint allows for ease of opening and closing the jaws 10 and12. The needle holder jaws taper in both width and heigth to a terminal,rounded point. This pointed tip allows for good directional placementand visualization of needle position by the surgeon using theinstrument.

The needle holding jaws with opposed surfaces 24 and 26 containspecialized transverse channels 28 and 30, shown in greater detail inFIGS. 2-4. The width of the transverse channel varies by means ofsliding member 38. Construction of the needle holder jaws is of surgicalstainless steel. Alternatively the jaws may be made of high impactplastic to afford a disposable nature to this functional section of thesurgical instrument. This would allow for cleaning and sterilizing thereusable parts and for discarding the jaws in the case of fatiquedsurfaces that no longer securely grasp the suture needle.

FIG. 2 is a section across one needle holder jaw. The sliding member 38is of surgical stainless steel or tungsten carbide construction. Allstainless steel or tungsten carbide parts can be sterilized and re-used.Alternatively, it is made of high impact plastic for disposableapplication. The sliding member 38 is rectangular in shape and comprisesa major portion of the needle holder jaw. The surface of the slidingmember is preferably finished in a serrated or cross-hatched pattern.This provides an alternative grasping surface for a needle or suture(the latter being the case when the needle holder is used to tie thesuture). The sliding member moves back and forth as constrained bylongitudinal grooves 40. The longitudinal grooves are provided in theside of the needle holder jaw to a depth to securely hold tabs 46 and48. Two or more tabs 46 and 48 which are part of the rolled over edge ofthe sliding member maintain the sliding member in position on the needleholder jaw. The motion of the sliding member back and forth in thelongitudinal grooves 40 allows for variation in the width of thetransverse channel described in FIG. 1 and 5-7.

FIG. 3 is a detailed top view of the needle holder jaw. In the picturedembodiment the sliding member 38 moves in the longitudinal grooves 40 bymeans of four tabs 46, 48, 50, 52. These tabs are introduced and removedthrough vertical openings 56, 58, 60, 62, in the side of the needleholder jaw to allow the tabs to enter the longitudinal groove 40. Onceseated in the groove the sliding member is held in position by a biasingspring 42, such as a leaf spring, in proximal compartment 44. The leafspring is held in place in the compartment by one fitting the ends intospring locating grooves in the end wall of the compartment. Thisprevents the spring from inadvertant dislocation from the compartment.The spring 42 exerts moderate forward pressure on the sliding member 38.The amount of forward pressure is such that a suture needle can beeasily placed into transverse channel 28 and the sliding member 38 moveto accomodate the size of the needle.

Once the needle is in the transverse channel and the needle holder jawsare closed, the sliding member is firmly held in place against theneedle both by the biasing member and by the closing force of opposingjaws. In a preferred embodiment, the suture needle is further securelyheld in position in the transverse channel 28 by virtue of one or moretransverse ribs or elevations 66 in the floor of the transverse channel.These ribs mate with corresponding longitudinal grooves in the surfaceof the suture needle as will be described in more detail with referanceto FIGS. 4-7. The surfaces of the needle holder jaw not involved withthe transverse channel are preferably of a serrated or cross hatcheddesign to allow for alternate needle grasping capability.

FIG. 4a is an oblique view of a preferred embodiment of the needleholder jaw. The sliding member 38 is positioned such that in a restingstate there is a 1.5 mm opening at the front of the transverse channel28. This allows ease of placement of a suture needle as it seatsdirectly in this opening. If the diameter of the needle is larger than1.5 mm the sliding member moves back to allow full seating of the largerdiameter. As the sliding member moves back there is compression of thespring 42 in compartment 44.

The sliding member 38 can be removed and replaced in position bycompressing the spring 42 with maximum pressure pushing it back untiltabs 46, 48, 50, 52 meet four matching vertical openings 56, 58, 60, 62,in the upper edge of the longitudinal grooves 40. The motion is to pushthe sliding member back as far as possible so that the tabs engage thevertical openings and the sliding member can be lifted up and free. Thereverse motion allows replacement of the sliding member in the needleholder jaw.

The opening of the spring compartment 44 is covered by an extension 54of the sliding member 38. In addition, there is an inferior smallprojection 64 of the sliding member 38 which is in contact with andholding the spring 42 in functional position.

The depth of the transverse channel 28 is approximately 1 mm. In thefloor of the transverse channel 28 there are one or more transversetriangular ridges or elevations 66 which are designed to engagelongitudinal grooves 68 on the surface of the suture needle 70. Thepreferred cross-section of the suture needle is depicted in FIG. 4b.This configuration allows the suture needle 70 to seat in the transversechannel 28 and maintain its position at a right angle to the axis of theneedle holder jaws. In surgical applications the needle must maintainits location in the needle holder as it passes through tissue. Anymotion of the suture-needle from the desired right angle results in losttime or a lost needle in addition to the potential damage of tissue byunwanted needle motion.

FIG. 5 shows the side view of the needle holder jaw with a suture needle70 in position in the transverse channel 28. This needle is fairly smallresulting in opening of the sliding member 38 only a minimal amount.FIG. 6 depicts a larger needle in the transverse channel 28 resulting inan increased opening of the sliding member 38. Note that in both FIG. 5and 6 there is mating of the transverse ridges 66 in channel 28 with thegrooves 68 in the needle 70 surface. This provides a secure grasp of theneedle 70. The firm positioning of the suture needle 70 is furtherenhanced by the closed approximation of the opposed needle holder jaws10, 12 that aid in maintaining the sliding member 38 against the seatedneedle 70. There are three separate constraints being appliedsimutaneously to the suture needle to maintain its position in thetransverse channel 28. First, the transverse ridges 66 in the channelare mating with the grooves 68 in the surface of the suture needle 70 toinhibit lateral movement. Second, the forward pressure of biasing by thesliding member 38 on the needle maintains the needle in the transversechannel 28. The third force is the pressure of the closed jaws 10, 12 ofthe needle holder 14 on each other which is maintained by the lockedratchet mechanism 22. This last force is additive to the first two bymaintaining the sliding member 38 firmly against the needle 70 and bykeeping the needle 70 seated on the transverse ridges 66 in thetransverse channel 28. Generally the needle 70 will seat in the lowerjaw as the convex surface of the needle is pushed into place in theneedle holder jaw. Both jaws 10, 12 are the same, so the uppertransverse channel 30 facing the concave surface of the needle will alsobe utilized if the needle is thick enough to activite the sliding member38. With a suture needle 70 properly seated the opposing surfaces 24 and26 of the needle holder jaws will be in contact.

Alternatively, depending on the size of the needle holder 14 and thesuture needle 70 being used, only one jaw of the needle holder 14 mighthave the specialized transverse channel 28 herein described. Theopposing needle holder jaw surface 24, 26 would be of flat, conventionaldesign without a transverse channel 28. This may require a top/bottomdesignation to the needle holder jaws 10, 12 for ease of use. This canbe done by marking the needle holder handles or color coding thetransverse channel 28 for quick orientation. In addition, it is possiblethat in small needle holder, applications that there would not be asliding member 38 in the design. This would require the width of thetransverse channel 28 in the needle holder jaw to be of a fixeddimension. Thusly, in this situation suture needles 70 of only one sizewould fit into the transverse channel 28. This configuration may bedesirable in needle holders for fine vascular or ophthalmologic surgery.

Construction of the improved needle holding instrument is of surgicalstainless steel or tungsten carbide. Alternately, the specialized jawsmay be constructed of high impact plastic and designed to be disposibleand replaceable, as a unit on the needle holder. FIG. 7 shows a sideview of a disposable configuration in which the entire jaw mechanism canbe removed from the needle holder. There is a central longitudinalsupport 72 extending forward from the needle holder pivot joint 20. Thejaw mechanism with specialized transverse channel 28 fits over thelongitudinal support 72 and snaps in place. This is done by means of atongue and groove joint 74 at the distal portion and a snap-lock 76 atthe proximal end of the needle holder jaw. The tongue and groove joint74 has an angled projection of metal from the support 68 which fits intoan angled groove in the inner surface of the disposable jaw insert. Thesnap-lock mechanism 76 consists of a transverse spring on the jaw, theends of which fit into corresponding grooves in the longitudinal support72 as the jaw is pressed into position. The motion to place the jawinsert is to engage the distal tongue and groove joint 74 first thenpress the rear of the jaw down to allow the spring ends to snap intoplace in the grooves in the longitudinal support 72. To remove thedisposable needle holder jaw insert, the proximal snap-lock joint 76must be disengaged on one side with an instrument then the insert can belifted up and off the longituidal support.

The above described embodiment of the invention is the preferred form.However, it is understood that changes in the design construction may bemade without departing from that which is herein claimed. For example,the transverse channel 28 may be placed at an angle other than a rightangle to the axis of the needle holder for certain surgicalapplications. The needle 70 may be more or less curved, or may bestraight. The needle grooves 68 and ridges 66 may be triangular,squared, rounded or eccentric. The spring 42 may be a leaf or coiledspring. The sliding member 38 may provide no tabs, 2 tabs, 4 tabs, orthe like. Substitute materials may be used.

I claim:
 1. A suture needle holding surgical instrument comprising:firstand second elongated members, each of which form finger loops at a firstend and jaws to hold a suture needle at a second end; said first andsecond elongated members being pivotally mounted in a scissorsconfiguration; at least one jaw with a specialized transverse channel inan inner jaw surface; a sliding member; and a biasing member associatedwith said sliding member and said at least one jaw, for moving saidsliding member to adjust the width of said transverse channel inresponse to the introduction of a suture needle into said transversechannel.
 2. An instrument of claim 1 wherein the instrument includes aratchet locking mechanism for holding the jaws in a pivotally closedposition.
 3. An instrument of claim 1 wherein said transverse channelincludes a floor having at least one transverse ridge for mating with acorresponding groove in a suture needle surface.
 4. An instrument ofclaim 3 wherein both said first and second elongated members have aspecialized transverse channel including a floor having at least onetransverse ridge in said channel.
 5. An instrument of claim 1 whereininner surfaces of the needle holder jaws not defining said transversechannel are of a serrated configuration.
 6. An instrument of claim 1wherein said sliding member and entire jaw on the end of the firstelongate member as well as the entire jaw on the end of the secondelongate member are removable.